Provider Demographics
NPI:1861550352
Name:MEIVES, ALOYSIUS FRANCIS IV
Entity type:Individual
Prefix:
First Name:ALOYSIUS
Middle Name:FRANCIS
Last Name:MEIVES
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:AL
Other - Middle Name:F
Other - Last Name:MEIVES
Other - Suffix:IV
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2328 JAMIE CIR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-9000
Mailing Address - Country:US
Mailing Address - Phone:859-585-3002
Mailing Address - Fax:606-693-9643
Practice Address - Street 1:100 HIGHWAY 15 S STE 136
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:KY
Practice Address - Zip Code:41339-8636
Practice Address - Country:US
Practice Address - Phone:606-693-9644
Practice Address - Fax:606-693-9643
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4191225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0787601Medicare ID - Type Unspecified